What
Is Inhibited Sexual Desire?

Inhibited sexual desire (ISD) is a medical condition with only
one symptom: low sexual desire. A person with ISD seldom, if ever, engages in
sexual activities. They don’t initiate or respond to a partner’s sexual
overtures. This condition is also known as hypoactive sexual desire disorder,
sexual aversion, or sexual apathy.

ISD is one of the more common problems couples face today.

ISD can be a primary or a secondary condition. This is an
important distinction for treatment purposes. It’s a primary condition if the
person with ISD has never had sexual desire.

It’s a secondary condition if the person with ISD began a
relationship with normal sexual desire, but later became disinterested.

ISD can also be understood as a relationship issue, which helps
to guide medical or psychological treatment. Situational ISD means that the
person with ISD has sexual desire for others, but not for their partner.
General ISD means the person with ISD has no sexual desire for anyone.

There’s no true normal range for sexual desire because it
naturally fluctuates throughout life.

Major life changes that can affect your sexual desire include:

pregnancy

partner changes (marriage or divorce)

physical or psychological disability

menopause

work and life imbalance

People seek help when ISD puts stress on their relationships.
However, the problem isn’t always a case of ISD. One partner may have an
overactive sexual desire. This creates a ‘sexual mismatch,’ which also puts
undue strain on a relationship. When this happens, it can:

erode affection

cause neglect of the nonsexual relationship

cause the other partner to lose sexual interest

What
Causes Inhibited Sexual Desire?

ISD is often an intimacy issue. Common relationship factors that
can reduce sexual desire include:

conflicts

toxic communication

controlling attitudes

contempt or criticism

defensiveness

breach of trust (infidelity)

lack of emotional connection

spending too little time alone

People who are most at risk of developing ISD have experienced
trauma (incest, rape, or sexual abuse), or were taught negative attitudes about
sex by their family (or by their religion) while growing up.

There are many medical and psychological factors that can also
hamper sexual desire, including:

side effects of medicines (especially
antidepressants and anti-seizure drugs)

hormonal changes

low testosterone (in both women and men)

menopause

Nonsexual Diseases

Certain diseases can affect libido (sexual desire). The most
common of these are:

high blood pressure

cancer

coronary heart disease

sexually transmitted diseases (STDs)

neurological issues

diabetes

arthritis

Sexual Dysfunction

Women who have had breast or vaginal surgery may experience
sexual dysfunction, poor body image, and inhibited sexual desire.

Erectile dysfunction (ED) is a man’s inability to achieve an
erection. This can cause ISD in the man, who may feel he is a failure sexually.
Perceived failure in both men and women (failure to orgasm, for example) can
cause the individual experiencing the dysfunction to have ISD.

Erectile dysfunction isn’t necessarily due to aging. It can be a
sign of medical problems such as:

diabetes

heart disease

clogged blood vessels

In the majority of ISD cases, medical conditions aren’t as
influential as each partner’s attitude about sexual intimacy.

How
Is Inhibited Sexual Desire Diagnosed?

You may have ISD if you experience low sexual desire and it
causes you distress personally or in your relationship.

Your doctor can look for causes of ISD and recommend strategies
that may help. After recording your medical history, the doctor may prescribe
some or all of the following tests:

blood tests: to check for diabetes, high
cholesterol, thyroid problems, or low testosterone

pelvic exam: to check for physical changes, such
as vaginal dryness, painful areas, or thinning of the vaginal walls

blood pressure check

tests for heart disease

prostate gland examination

After treating any medical conditions, your doctor may recommend
evaluation by a sex therapist or psychiatrist, either individually or as a
couple.

What
Are the Treatments for Inhibited Sexual Desire?

Counseling

Psychological and sexual counseling are the primary treatments
for ISD. Many couples first need marriage counseling to improve their nonsexual
relationship before addressing the sexual component directly.

Communication training is one option that teaches couples how to:

show affection and empathy

respect each other’s feelings and perspectives

resolve differences

express anger in positive ways

Sexual counseling will help couples learn how to:

devote time and energy to sexual activities

find interesting ways to sexually approach their
partner

decline sexual invitations tactfully

You may need individual counseling if your ISD stems from sexual
trauma or sexual negativity learned as a child.

Private counseling or drug therapy can treat male problems such
as impotence or delayed ejaculation. Drugs such as Viagra can help with ED. It’s
important to keep in mind that these drugs only enable erections; they don’t
cause them.

Hormone Therapy

The hormones testosterone and estrogen greatly influence a woman’s
sex drive. Small doses of estrogen delivered via a vaginal cream or a skin
patch can increase blood flow to the vagina. However, long-term estrogen
therapy increases the risk of breast cancer and heart disease.

Female testosterone therapy may also help, but it isn’t yet
approved by the Food and Drug Administration for treatment of female sexual
dysfunction.

Testosterone side effects include:

mood and personality changes

acne

excessive body hair

Lifestyle Changes

Certain lifestyle changes can have a positive effect on sexual
desire while also improving overall health.

Set aside time for intimacy. If one or both partners’ schedules
are very busy, it can help to put dates on your calendar to make intimacy a
priority in your relationship.

Exercise. Working out can elevate your mood, improve libido,
increase stamina, and create a more positive self-image.

Communicate. Talking openly and honestly fosters a closer
emotional connection. It may also help to tell your partner your sexual likes
and dislikes.

Manage stress. Learning better ways to manage financial
pressures, work stress, and the hassles of daily life can help you to relax.

What
Is the Long-Term Outlook?

Couples therapy is often a successful treatment for ISD. Treatment
can be more challenging for men — both in counseling and drug therapy.

Counseling can be a lengthy process, but it can enhance a
couple’s attitude toward each other and improve their general outlook on life.